Wednesday, 2 March 2005
I welcome the Minister of State at the Department of Finance, Deputy Parlon, to the House. The matter I wish to raise concerns the need for the Tánaiste and Minister for Health and Children, Deputy Harney, to urgently put in place the disabled drivers medical appeal board. Those seeking redress from the now defunct board have been waiting in limbo for three months and the waiting list is two years, with no acknowledgement of correspondence and no indication of the status of their appeal or if an appeals process is in place. Those in need of support have been badly treated. The matter has been transferred to the Department of Finance given that the Minister of State has overall responsibility for the board, despite the fact that the Department of Health and Children has responsibility for providing the primary medical certificate.
The essence of the problem lies in the definition of who is eligible for the certificate, a definition which is archaic. The medical criteria to enter into the scheme limits access to those who are severely or permanently disabled. According to the criteria laid down, applicants must be wholly or almost without the use of both legs or be severely restricted in the movement of the lower limbs. It is unbelievable that stroke victims and motor neurone disease sufferers as well as those with MS are excluded from the scheme. The medical requirements for the scheme are much too restrictive. Conditions do not allow for discretion and are deliberately restrictive.
The Ombudsman, who has successfully challenged the scheme on three or four occasions, recently outlined serious issues in regard to it. The scheme was first introduced in 1994. Since then, approximately 8,000 people have benefited from it. That between 400 and 600 individuals are awaiting an appeal is an indication of the numbers seeking access. The criteria are so restrictive that elderly spouses and children are dependent on the passenger concessions to buy extra equipment when no longer able to lift their charges in and out of the vehicles. I welcome the fact that an element of discretion will be introduced into the new appeals board. I am pleased that following a long delay the appeals board has been enhanced by two additional medical doctors and secretarial staff.
It is frustrating for those who have made appeals in the past that they do not know where their papers are and when they contact the board they get an answering machine and no reply. That is frustrating for those in urgent need of assistance. That VAT and VRT is refunded to the applicants is of assistance. In many instances where assistance is provided, it prevents people from being institutionalised. For that reason the concession is value for money. I urge the Minister of State to ensure that steps are taken immediately given that there are 600 people on a two-year waiting list seeking an appeal. Something has gone terribly wrong over a period which has allowed this problem to develop. An amnesty will have to be declared to enable the board, when it is put in place along with proper funding, to begin operating on a level playing pitch and deal with the new applicants. Where medical evidence is provided, there should be no delay in allowing those appeals to go through.
Where the word of the general practitioner, who has been in constant contact with the applicant, is not taken it is a sorry state of affairs. An amnesty should be allowed for a short period for all existing applicants. The amount of money involved is small and would improve the conditions of both the applicant and his or her spouse and children, or whoever is caring for the applicant. That would be an indication that the Government is serious about caring and responding to those who are disabled and immobile.
I do not know the definition of "mobility" within the Department of Finance or the Department of Health and Children. At local level, responsibility which formerly rested with health boards is now a matter for the Health Service Executive. Some element of discretion will have to be taken on board to allow this valuable scheme to function properly.
I welcome the Minister of State, Deputy Parlon, to the House and thank Senator Ulick Burke for sharing time with me to allow me to support him on this issue. I could name people who are close friends both of mine and the Minister for State who, fortunately for them, are on the right side of the border with Offaly. These people have a difficulty with this legislation and the lack of facility for appealing a decision in which they were refused a primary medical certificate. They were urged to contact Dr. Angela McNamara, the chairperson of the disabled drivers medical board of appeal in Dún Laoghaire. As public representatives we discovered there is currently no appeals board. I understand the Department of Finance has signed off on an agreement to increase the membership of the board from three to five. When will the head of the board or the consultant be appointed? When will a secretary to the board be appointed to respond to public representatives and, more important, to the people who are waiting on an appeal? When will they receive a response? The Department of Finance and the Department of Health and Children have treated people with a disability in a disgraceful manner.
I know of an individual who suffers from post-polio syndrome. He was refused a primary medical certificate. The first condition for such a certificate is that a person has lost the use of one leg and the second condition is a partial use of the second leg. This person fulfils those conditions yet he was refused and he is being denied a right of appeal. He is waiting for a response to his letters and telephone calls. It is disgraceful behaviour on the part of the Government to treat people with disabilities in such a manner. I understand the CEO in the National Rehabilitation Institute, Mr. Greene, had serious problems with the manner in which he was expected to finance the operation over the years.
I am pleased the Minister of State has come to the House tonight. I ask for this problem to be addressed. The treatment of these people is appalling. They are falling between two Departments on this issue and no letters or telephone calls are being answered. I am hopeful the Minister of State will achieve a proper solution to this problem and that immediate action will be taken. It is appalling that people must wait more than two years. I know of an individual who is waiting over a year for a right of appeal.
I am pleased to take this opportunity to clarify the matter relating to the disabled drivers medical board of appeal. The disabled drivers and disabled passengers tax concessions scheme provides for certain tax concessions in respect of the purchase and running of a vehicle for persons who meet particular medical criteria relating to physical disablement. The tax concessions include remission or replacement of vehicle registration tax, VRT, repayment of value added tax, VAT, in the purchase of the vehicle and a repayment of VAT on the cost of adaptation of the vehicle. Repayment of the excise duty on fuel used in the motor vehicle and exemption from annual road tax to local authorities are also allowed.
The criteria for medical eligibility are as follows: The applicant is wholly or almost wholly without the use of both legs; the applicant is wholly without the use of one leg and almost wholly without the use of the other leg such that the applicant is severely restricted as to movement of the lower limbs; the applicant is without both hands or without both arms; the applicant is without one or both legs; the applicant is wholly or almost wholly without the use of both hands or arms and wholly or almost wholly without the use of one leg; the applicant has the medical condition of dwarfism and has serious difficulties of movement of the lower limbs.
In order to qualify for tax concessions under this scheme, a person must be in receipt of a primary medical certificate issued by the senior area medical officer in the local Health Service Executive area. Where a primary certificate is refused, this maybe appealed to the disabled drivers medical board of appeal whose decision is final.
The medical board of appeal of regulated by the Disabled Drivers and Disabled Passengers (Tax Concessions) (Amendment) Regulations 2004. These provide that the Minister for Finance may appoint five medical practitioners to the board on the nomination of the Minister for Health and Children, each for a period of four years. The amended regulations were signed by the Minister for Finance on 23 July 2004 and provided for the expansion of the panel of medical practitioners serving on the medical board of appeal from three to five; and amendment of the appeals process by introducing a six-month waiting period between an appeal and a subsequent application and introducing the requirement for a second application to be certified by a registered medical practitioner to the effect that there has been material disimprovement in the medical condition since the previous application. These changes were introduced on foot of recommendations of the interdepartmental review group report established to report to the Minister for Finance on the operation of the scheme.
These changes were recommended in order to improve the operation of the appeals process and enable the backlog of appeals to be tackled. In particular, the expansion of the board from three to five medical practitioners will facilitate more meetings of the board as only three members are required for an a appeal hearing.
As regards the current difficulties referred to, the Departments of Finance and Health and Children are engaged in the process of reconstituting the board, following a number of staff changes late last year and a number of administrative issues. The two Departments have been consulting intensively in order to put arrangements in place which should lead to an improved and more streamlined service from the reconstituted board. The issues involved are complex and, therefore, the process has taken some time. However, I understand that significant progress has been made and that the last outstanding matters are now being resolved. On the basis of this progress, it is expected that the board will be resuming operation within a matter of weeks.